2008-057 Burkich Dentistry TOWN OF QUE E NSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
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Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20080057 Date Issued: Wednesday, July 23, 2008
This is to certify that work requested to be done as shown by Permit Number P20080057
has been completed.
Tax Map Number. 523400-301-008-0001-016-000-0000
Location: 366 AVIATION Rd
Owner. KIT ELLEN BURKICH
Applicant KIT ELLEN BURKICH
This structure may be occupied as a:
Sign
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve ther,DJ4
property owner of the responsibility for compliance with Site Plan,
1 Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
1
TOWN OF QUEENSBURY
FoN 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080057 Application Number. A20080057
Tax Map No: 523400-301-008-0001-016-000-0000
Permission is hereby granted to: KIT ELLEN BURKICH
For property located at: 366 AVIATION Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: KIT ELLEN BURKICH
366 AVIATION Rd Sign
QUEENSBURY,NY 12804 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
K.D. WHEELER CUSTOM SIGNS
16 RICHARDSON STREET
QUEENSBURY,NY
Plans &Specifications
2008-057
CHANGE OF COPY: 15.83 SQ FT SIGN TO READ "BURKICH DENTISTRY"
$0.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday, February 22,2009
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T o ee r' bruary 22, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY 1,,, ( FEB 0
TAX MAP NO. - ' f r -Hi PERMIT NO. t (,i:5 PERMIT FEE Ail
' €OF QUEENSS RY
APPROVALS: DEPOSIT .'f PL Coots
SIGN PERMIT APPLICATION:
A permit must be obtained before installation of your permanent sign. All applicants'spaces on this application must
be completed and must appear on the application form.
OWNER: 14I T jv LLC.J I vt+LK C l-I INSTAL I FR/BUILDER: (.t.)NE r"Lc-7Z C, S7�Fri
ADDRESS: 36, A V.A i 1 o,.-� Q 6 ADDRESS: I O /2,C NA eD .SO,�..'s e i - y
PHONE NOS. -7 67 f f 77 PHONE NOS. /y 753 4.ALL.)
LOCATION OF PROPOSED INSTALLATION:(LEGAL ADDRESS) J C9 LD A i A7i 6 Cr'6Y
BUSINESS COMPLEX/PLAZA/MALL NAME:
BUSINESS NAME:
CONTACT PERSON FOR SIGN CODE COMPLIANCE: No t-I_,/ L()N c�E/err,— PHONE: 7 (.0C 3 ,a 6
TYPE OF SIGN PROPOSED: X freestanding //wall _awning projecting
IF SIGN IS TO BE ILLUMINATED,PLEASE INDICATE: _Internal X External Incandescent `Neon Other
DO SIGNS CURRENTLY EXIST ON THE PROPERTY? X Yes No
IF YES,LIST ALL EXISTING SIGNAGE:
The application creates a change New
in the following existing site Change in number of signs from to
conditions(fill in all applicable Change in setback for sign from to �
spaces): X Change in size of sign from f 6,4 2_. to IS. 3 l•41
Change in height of sign from to
y Change of wording/copy yfrom: 72. C, l3ur2KrC / a
-BlAte_k.(Gi{ DEA.i"r7 S'T"g-y
Sign Wording/Copy: it (Cl C. N .D E r.l;t S7 r2 y
Sign size: Length 3&i x Width (cO =Total Sq.ft. 15,$3 Sign Height(freestanding sign): q.
Color and Material to be used: N b Lk - I Jo R `/ 4 Bur
I Provide 2 copies of a scaled drawing or surveyed plot plan with the following information:
o Location of sign(walls signs: drawing of the facade
the sign will be located on,indicate sign on facade)
o Height of freestanding sign QUESTIONS? CALL 761-8256 OR EMAIL
o Depth of projecting sign codesaqueensburv.net
o Distances from front and side property lines. VISIT OUR WEBSITE FOR MORE INFORMATION
I Provide 2 drawings or photos of sign design. www.queensburv.net
I Provide Applicant and Owner's signature(permission
for placement of sign on the property or building).
Declaration: To the best of my knowledge,the statements contained in the application,together with the plans and
specifications submitted,are a true and complete statement of all proposed work to be done on the described premises and that
all provisions of the Zoning Ordinance,and all other laws pertaining to the proposed work shall be complied with,whether
specified or noted,and that such rk is authorized by the fow owlet
APPLICANT SIGNATUR 7k) . 7,,(.�--L1. ATE: I/ &lU gt
I hereby authorize the applicant to placcxla sign on my property or building.
OWNER SIGNATURE: ? DATE:
Town of Queensbury•Community Development Office• 742 Bay Road, Queensbury, NY 12804
I
,-1.- Yle 4.___________________ lopp at BURKICH ;
DENTISTRY '`
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Dr. Kit E. Burkich, DDS, FAGD
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o 2007 Cr Cite r en e
This design is copyrighted and is CUSTOM 'SIGNS Drawing:
the design
sloe property of DrawIn r IC Si$I /&/o
The Wheeler Art Group,Inc. Date: 1/17/0 M
It Is not to be copied or reproduced In any way A DIVISION OF THE WHEELER ART GROUP, INC. ,Vt
until approved and accepted 16 Richardson St. Queensbury, NY 12804
r't
through purchase by the client. Phone/Fax: 518-793-2620 email:kdwheeler(Gadeiphla.net Approved by:
www.wheelersig ns.com